ACA-compliant coverage

The healthcare laws in the United States have changed a lot over the last number of years. With the Affordable Care Act, also called the ACA or Obamacare, plans need to maintain certain standards and follow certain regulations to remain ACA compliant. For coverage to be ACA compliant, certain essential benefits need to be covered. There are other details about healthcare insurance plans that need to be noted as well. Healthcare coverage is an important part of many people’s lives, helping protect them from intense financial hardships when emergencies and other non-life-threatening circumstances involving health are concerned.

What Is ACA-Compliant Coverage?

ACA compliant coverage must include insurance coverage for the ten essential benefits listed in the Affordable Care Act. Also, these essential benefits must be covered with no lifetime or annual benefit maximums. Lastly, each ACA compliant plans must follow and adhere to consumer protections that are built into the Affordable Care Act. During open enrollment, ACA compliant plans are guaranteed issue. This means that pre-existing conditions are not a factor in a person’s eligibility. Also, the plans cannot be arbitrarily rescinded, and insurance carriers need to comply with medical loss ratio rules which require at least 80% of premiums to be spent on medical expenses

Regardless of whether an individual policy is purchased or sold on-exchange or off-exchange, the plans must be Affordable Care Act compliant. Keep in mind the requirements for larger group plans, meaning plans for 51 or more employees in most states, are different in terms of compliance. Also, keep in mind that plans that were in force before 2014 sometimes have exemptions from the Affordable Care Act rules.

Some plans are not considered major medical insurance and therefore are not regulated by the Affordable Care Act. These plans do not have requirements that say the guidelines for ACA plans need to be followed. Plans that fit this description do not fulfill the shared responsibility provision.

Who May Apply?

To be eligible for an insurance plan that is compliant with the Affordable Care Act, certain requirements must be met. First off, a person applying for a healthcare plan in the United States must live in the country. People who are living in other countries might not be eligible for an Affordable Care Act plan. Also, people applying for plans must be citizens of the United States, or lawfully present. US nationals can also qualify for plans. Keep in mind that if you have a Medicare coverage plan, you are not eligible for the Affordable Care Act plans in addition to your Medicare coverage. Lastly, people who are currently incarcerated can not apply for ACA insurance plans.

Who Needs Insurance Coverage?

People who want comprehensive individual major medical insurance that is compliant with the ACA are common. If you work part-time or full-time and do not have an employer-sponsored health insurance plan, you should consider getting health insurance coverage quotes here. In addition, people who are self-employed, including freelancers and consultants, and do not get health insurance through their employer, should look into picking up a plan. In some cases, a person experiences a qualifying life event. This means a special enrollment period will begin. Many people choose to buy a health insurance plan at this time. Lastly, there are some states where short-term medical insurance coverage is not available. This may be a reason to pick up a longer-term health insurance plan.

Final Notes

This website has the tools you need to get the best prices for health insurance available. Make sure the plan you are purchasing is ACA compliant and that you know the ten listed basic essentials are covered. There are many benefits to getting an ACA compliant policy, and the free quotes here can help you save.